The scope of medullary fixation of the femur is now well defined. Under ideal circumstances, this method can now be accepted as sound therapy, offering many advantages over older and more orthodox forms of treatment. The nail provides internal fixation sufficiently strong and rigid to eliminate the need for casts, splints, or braces. Nursing care is simplified. Early ambulation and weight bearing and mobilization of joints minimize the period of hospitalization and convalescence and decrease the final degree of disability to a minimum. Impaction or coaptation of the fracture surfaces is recognized as a desirable physiological stimulus to union. The medullary nail is a near-perfect mechanical appliance to take advantage of this favorable factor. Over-zealous attempts, however, to capitalize on early mobilization and restoration of function in improperly selected cases can lead only to trouble. Surgeons with the most experience recognize the limitations of medullary nailing, and supplement the nail during p...